Introduction to Family Counseling

How do you define family?

What constitutes a family? What are the characteristics of a healthy family?

What are some strategies that you have seen families use to improve relationships? Why do families sometimes resist taking obvious steps toward improvement?

General Concepts

Systems Theory

Functionalism

More than the sum of its parts

How is symptom maintained? Boundaries

Feedback Loops

Structuralism

Negative & Positive

Circular Causality

Family Life Cycle

Beginning
Differentiating from family of origin Negotiating rules

Adolescent
Separation & indvidualization Rules change Marital relationship changes

Infant/ Preschool
Transition to 3 Reorganizing rules Autonomy/ Attachment

Launching
Responsive vs. Reactive Reexamination of career/ marriage

SchoolSchool-age

Postparental

Communication patterns established Retirement Reorganizing Death of spouse Career changes Grandparenthood

Bowen Family Systems

Differentiation of self

Emotional cutoff Fusion

Triangles Family Projection Process

Multigenerational Transmission Process

Bowen contd

The problems of the past are visited in the future Goals of therapy:

Increase differentiation of self DeDe-triangulation

Structural Family Therapy

Family Structure

Hierarchical Reciprocal/ Complementary

Subsystems Boundaries

Manage proximity & hierarchy

Structural Family Therapy

Boundaries
Rigid

Permit little contact outside system Benefits:

Diffuse Few boundaries within system Benefits:

Independence Mastery

Mutual support Warmth Dependence Trouble relating to others

Limitations:

Limitations:

Little warmth, nurture Disengagement

Structural Family Therapy

Family Structure
Rigid Boundary Clear Boundary Diffuse Boundary Coalition Conflict Detouring Involvement Overinvolvement

Structural Family Therapy

Goals

Change structure of family

Altering boundaries Realigning subsystems

Structural Family Therapy

Techniques

Joining Working w/ interaction

Modify interactions

Who talks to whom? When? In what way? Enactments Spontaneous Bx Seq (e.g., interpretation)

Intensity Shaping competence B/w subsystems Focus on subsystem

Boundary making

Unbalancing

Diagnosing

Challenging assumptions

Experiential Family Therapy

Overview

Humanistic & Existential

SelfSelf-awareness SelfSelf-expression SelfSelf-actualization

Development of Problems

Result of suppression of feelings Lack flexibility

Experiential Family Therapy

Goals

Growth

Balance belongingness & individuation Emotional experiencing

Symptom relief

Through selfself-awareness & actualization

Experiential Family Therapy

Techniques
There are no techniques, only people

Family Sculpture

Family Art Therapy

Current

Identified patient Each member

Joint family scribble Family drawing

Future Family puppet interviews

Kinetic Family Drawing

Role Play

Emotion Focused Couples Therapy

Johnson & Greenberg Based on attachment theory Weak attachment conceal emotions use withdrawal, coerciveness, blaming negative interaction patterns Goals of therapy:

Reprocess negative emotional sequences

Narrative Therapy
Stories dont mirror life they shape it.

Narrative Therapy:
Basic Assumptions

All knowledge is constructed Stories shape how we interpret events People have good intentions & want to change People are NOT their problems People are effected by cultural discourses

Narrative Therapy:
Goals of Therapy

Externalization

Separate the person from the problem Find exceptions

Deconstructing problemproblem-saturated stories

CoCo-authoring new stories

Narrative Therapy:
Techniques

Clients tell problemproblem-saturated story Externalizing language Mapping the influence Relative influence questions Reauthoring the whole story Reinforcing the new story

Narrative Therapy:
Examples

Depression made your daughter act this way How does GUILT effect you? What does it say about you that you were able to battle ANGER this way? How much has the problem controlled you this past week & how much have you controlled the problem?

Interviewing a Problem

Example:

What areas of Johnnys life are you causing trouble with? Work? Friends? Do you interfere with his judgment? Opinion of himself? In which areas do you think you have the upper hand? What people in his left have kept free from your influence? How have they managed that? What about Johnny is making a bit of trouble for you? Does anything about Johnny and his family make you nervous?